Provider Demographics
NPI:1891012787
Name:JOAN M. WINSOR, MD
Entity Type:Organization
Organization Name:JOAN M. WINSOR, MD
Other - Org Name:JOAN M. WINSOR, MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:WINSOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-996-9981
Mailing Address - Street 1:28 WANDLING RD
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:WA
Mailing Address - Zip Code:98862-9714
Mailing Address - Country:US
Mailing Address - Phone:509-996-9981
Mailing Address - Fax:
Practice Address - Street 1:28 WANDLING RD
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:WA
Practice Address - Zip Code:98862-9714
Practice Address - Country:US
Practice Address - Phone:509-996-9981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-01
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00026581282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital